摘要
目的:研究右美托咪定多模式镇痛在老年结直肠癌根治术后的镇痛效果及其对认知功能的影响。方法:将接受结直肠癌根治术的60例老年患者作为研究对象,按照接受镇痛的方式不同分为Ⅰ组与Ⅱ组,每组各30例。两组均在术后行自控静脉镇痛,Ⅰ组在麻醉诱导前30 min给予右美托咪定多模式镇痛。对两组患者手术不同节点疼痛程度(NRS)评分、镇静Ramsay评分、认知功能(MESS)评分、术后24 h内自控静脉镇痛泵有效按压次数、舒芬太尼用药量、血清神经元特异性烯醇化酶(NSE)、血清神经功能指标S-100β水平及术后不良反应发生情况进行比较。结果:Ⅰ组术后4 h、8 h及12 h运动的时VAS评分、术后24 h内自控静脉镇痛泵有效按压次数、舒芬太尼用药量、术后24 h与72 h血清S-100β、NSE水平及术后不良反应发生率均低于Ⅱ组,术后4 h与8 h时镇静Ramsay评分、术后24 h与72 h MESS评分均高于比Ⅱ组,差异有统计学意义(P<0.05)。结论:右美托咪定多模式镇痛有助于提高老年结直肠癌患者根治术后镇痛效果及安全性,值得临床应用。
Objective:To study the analgesic effect of dexmedetomidine multimodal analgesia on the analgesic effect and cognitive function of elderly patients with colorectal cancer after radical resection.Methods:60 elderly patients with colorectal cancer undergoing radical operation were divided into group Ⅰ and group Ⅱ,30 cases in each group.Both groups underwent patientcontrolled intravenous analgesia after operation.Group Ⅰ was given dexmedetomidine multimodal analgesia 30 minutes before induction of anesthesia.The resting(NRS)score,sedation ramsay score,cognitive function(MESS)score,the number of effective compressions of the selfcontrolled intravenous analgesia pump and sufentanil within 24 hours after surgery the dosage,serum neuronspecific enolase(NSE),serum neurological function index S-100β level,and postoperative adverse reactions were compared between the two groups.Results:In group Ⅰ,the VAS score during exercise at 4 h,8 h and 12 h after operation,the number of effective compressions of the self-controlled intravenous analgesic pump within 24 h after operation,the dosage of sufentanil,the level of serum S-100β and NSE at 24 h and 72 h after operation.The incidence of postoperative adverse reactions were lower than those of group Ⅱ.Ramsay scores for sedation at 4 h and 8 h after surgery and MESS scores at 24 h and 72 h after surgery were higher than those of group Ⅱ,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine multimodal analgesia can help improve the analgesic effect after radical resection of colorectal cancer in elderly patients,and it is safe and worthy of clinical application.
作者
董福生
李广伟
孟卉
于刚
许玲
DONG Fu-sheng;LI Guang-wei;MENG Hui;YU Gang;XU Ling(Department of Anesthesiology,the Second Hospital of Qinhuangdao,Qinghuangdao 066600,Hebei,China)
出处
《川北医学院学报》
CAS
2021年第2期180-183,共4页
Journal of North Sichuan Medical College
基金
河北省秦皇岛市科学技术研究与发展项目(201602A109)。
关键词
老年
结直肠癌根治术
右美托咪定
多模式镇痛
疼痛程度
认知功能
Elderly
Radical resection of colorectal cancer
Dexmedetomidine
Multimodal analgesia
Pain degree
Cognitive function
